Effect of bacterial vaginosis on preterm birth: a meta-analysis

Purpose: Bacterial vaginosis is a common genital tract disorder. It can lead to preterm birth, but its contribution is equivocal. Bacterial vaginosis is curable and, if diagnosed and appropriately treated, may reduce preterm births. The study desired to confirm the association between bacterial vaginosis and preterm birth.

Methods: It was a meta-analysis. We included articles published from 2008 to 2022. The authors included studies that measured the association between bacterial vaginosis and preterm birth by relative risk/risk ratio (RR) or odds ratio (OR). We excluded studies with qualitative data. The study utilized five search engines, PubMed, Scopus, Google Scholar, Cochrane, and LILAC. We used the statistical package for social sciences (SPSS) to draw forest and funnel plots separately for RR and OR.

Results: After an extensive search, the study included 20 articles yielding 26 relevant results with a total of 290,397 observations. This meta-analysis proves that bacterial vaginosis is undoubtedly associated with preterm birth. The overall relative risk of preterm delivery is about two-fold as overall OR1.79 (95% Confidence Interval 1.32-2.43). The overall RR of preterm birth is 1.44 (95% Confidence Interval 1.19-1.73).

Conclusion: Our study shows a significant association between bacterial vaginosis and preterm birth. The study concludes that investigation for bacterial vaginosis and management should be a part of the routine examination of a pregnant woman. The health system must initiate this strategy soon to reduce the prevalence of preterm births and consequent neonatal mortality.